The family-friendly C-section
We all know that babies can be born one of two ways—vaginally or by cesarean section, better known as C-section.
In general, moms don’t see their own C-section surgery. Delivery room staff set up a screen for a sterile field, but the screen also acts as a drape that keeps mom from viewing the procedure.
After baby is born, doctors will sometimes hold up the little one so mom can have a look before baby is then taken to a warmer or another room. Dad can go with baby if he likes, either to monitor the progress or to take some pictures.
Mom, however, is moved to the recovery area, where she might eventually get to see some pictures that dad snapped of their new family member. After a few hours, mom is taken to the obstetrics floor, where she’s finally reunited with her baby.
While many women have had C-sections this way for years, there are moms and providers who have been pushing for changes—when possible—for quite some time.
One important concept now circulating is the “natural” or “gentle” C-section.
In 2008 in England, some doctors thought it would be beneficial for mom to be more involved during and after the C-section, at least whenever possible.
Their first step entailed lowering the C-section screen so that parents could watch the birth process. The parents could also play music of their choosing and, if they preferred, they could turn down any bright lights.
After studying these cases, researchers found that the gentle C-section provided not just more patient satisfaction but also better breastfeeding success.
In Harvard studies, meanwhile, researchers have used a clear screen so that parents can watch the entire birth process. They also let moms engage in skin-to-skin contact and breastfeeding in the surgical suite immediately after the C-section.
In what other ways would a C-section qualify as gentle?
- Allowing dad to have skin-to-skin contact if mom is unable
- Placing EKG leads so mom can still enjoy skin-to-skin contact with baby
- Delayed cord clamping
- Prohibiting providers from talking about things unrelated to the birth (keeping them focused on mom and her experience)
- “Seeding” the baby
At Spectrum Health Gerber Memorial, the delivery rooms have a special screen for C-sections—it’s outfitted with a small window through which the baby can be passed to the nurse, then on to mom for some skin-to-skin contact. Gerber Memorial’s C-section birth plan has also been widely touted as a great template.
Is it truly possible for moms and babies to remain together immediately after C-section? Yes.
At Gerber Memorial, mothers slated for C-section are taken to a comfortable room where they’ll spend the bulk of their hospital stay. Even the preoperative procedures are done in that room. They’re taken to a surgical suite for the C-section, but then they return to their original room afterward.
In the surgical suite itself, the baby is handed to the mother, who immediately provides skin-to-skin contact and breastfeeding. Barring any complications in the surgery room, the mother returns to the regular room in the obstetrics unit to recover. After recovery she gets to return home.
The most important thing to remember: In ideal circumstances, mom and baby are together the whole time during these procedures. (If there are complications, baby may have to be taken to the nursery.)
Studies have shown that providing skin-to-skin contact immediately after a C-section can improve breastfeeding outcomes. A quick internet search produces many, many more studies attesting to the benefits of this practice.
It’s important to continue growing awareness, given that about 1 in 3 deliveries are now performed via this method.
The rate of C-section births has dropped slightly overall in recent years, but it is still dramatically higher than the rate 20 years ago. In 1996, C-sections accounted for about 20 percent of births; in 2015, they accounted for 32 percent.
The American Congress of Obstetricians and Gynecologists featured an interview with a Washington, D.C., doctor, Sarah Francis, MD, who talked about the process sometimes involved in promoting skin-to-skin time for moms who undergo C-Section. When possible, the baby is given immediately to the mother, “where the gown is taken down and the infant is placed skin-to-skin with the mother.”
Dr. Francis explained that her hospital has “both immediate skin-to-skin, where the baby is delivered and going immediately to the mom, as well as delayed where in some circumstances the infant might need to be evaluated by the pediatric team to make sure this will be safe.”
They also try to “increase the skin-to-skin time as long as possible, including up until the mom is taken to the post-anesthesia care unit. ”
The doctor added a word of caution—that “it takes some sitting down with all the team members and discussing and kind of going through that to make a protocol that would work for your hospital.”
Bottom line: The more that expectant moms know about their options, and the more empowered they feel to ask questions, the more likely it is we’ll see increases in gentle C-sections.